Acts of Congress

Although many acts of Congress have had some impact on the law governing veterans’ benefits, three acts define the current VA benefits adjudication system.  The Veterans’ Judicial Review Act of 1988 (“generally referred to as the “VJRA”).  Pub. L. No. 100-687, 102 Stat. 4105 (1988).  Among other things, the VJRA:

  1. removed the bar to paid representation of veterans by attorneys and allowed a reasonable fee to be paid;
  2. created a court to review decisions of the Board of Veterans’ Appeals; and
  3. opened a path to higher level review by the United States Court of Appeals for the Federal Circuit and the United States Supreme Court.

The Veterans Claims Assistance Act of 2000 (the “VCAA”) explicitly established the VA’s duty to assist veterans with their claims.  Pub. L. No. 106-475, 114 Stat. 2096 (2000).  Finally, the Veterans Benefits, Health Care, and Information Technology Act of 2006 permitted veterans to retain paid legal counsel following the filing of a Notice of Disagreement instead of having to wait until a Board denial.  Pub. L. No. 109-461, 120 Stat. 3403 (2006).

Statutes

Acts of Congress are not generally constructed in a way to be directly useful in resolving specific complaints or applications for benefits.  In many acts, the bulk of the language is detailed directions on how to amend existing statutes to add or delete a word, a phrase, or a complete section.  It is only after the directions contained in an act are implemented in a “statute” that a complete process can be applied to specific cases.  The entire set of statutes is called the United States Code (“USC”).

For VA, all of the applicable statutes incorporating Congress’ directions regarding VA benefits are located in Title 38 of the United States Code.

Regulations

As with other administrative agencies, VA actions are governed by both “regulations” (also called “rules”) and “informal” internal guidance such as policies, office manuals, and management directives.  The Administrative Procedure Act (APA) mandates that federal agencies publish their substantive rules, and amendments thereof, in the Federal Register, to provide notice to affected citizens and the opportunity to comment. See 5 U.S.C. §§ 552, 553; Morton v. Ruiz, 415 U.S. 199, 232 (1974) (APA provides that “administrative policies affecting individual rights and obligations be promulgated pursuant to certain stated procedures so as to avoid the inherently arbitrary nature of unpublished ad hoc determinations”).  The VA’s rules are found in Title 38 of the Code of Federal Regulations.  The reference is often shortened to “38 C.F.R.” or “38 CFR” followed by the section number (for example, 38 C.F.R. § 3.103, 38 CFR 3.103, or 38 C.F.R. section 3.103).  These rules must comply with the statutes in Title 38 of the United States Code, which is often similarly shortened to “38 U.S.C.” or “38 USC.”

Although it was VA policy to comply voluntarily with the APA since 1972, VA was not otherwise required by law to comply with the APA until the Veterans’ Judicial Review Act (VJRA) became effective in September 1, 1989. Compare Administrative Procedure Act, Pub. L. No. 89–554 (1966) (excluding matters relating to “benefits” from the APA), with Veterans’ Judicial Review Act, Pub. L. No. 100–687 (1988) (subjecting VA to the APA); see also 38 C.F.R. § 1.12 (1972) (“It is the policy of the Department of Veterans Affairs to afford the public general notice, published in the

Federal Register, of proposed regulatory development, and an opportunity to participate in the regulatory development in accordance with the provisions of the Administrative Procedure Act (APA). All written comments received will be available for public inspection.”). Thus, until passage of the VJRA, VA rules and regulations lived in “splendid isolation,” generally unconstrained by judicial review.  Brown v. Gardner, 513 U.S. 115, 122 (1994); see Pub. L. 100–687 (permitting judicial review by this Court and the U.S. Court of Appeals for the Federal Circuit (Federal Circuit)).

Given this unique history, it is not a surprise that substantive rules promulgated before the APA might be contained in the M21–1MR or a directive, letter, or other document (as described below).  See Buzinski v. Brown, 6 Vet. App. 360, 369 (1994) (noting that Rank v. Nimmo, 677 F.2d 692, 698 (9th Cir. 1982), held that “VA handbooks, circulars, and manuals” may have the “force and effect of law” if they prescribe substantive rules); Fugere v. Derwinski, 1 Vet. App. 103, 107 (1990) (the placement of a rule “in a procedural manual cannot disguise its true nature as a substantive rule”), aff’d, 972 F.2d 331 (Fed.Cir.1992).

Moreover, substantive rules promulgated prior to the statutory requirement that VA comply with the APA remain binding on the Secretary until they properly are revoked or amended.  See Fugere, 1 Vet. App. at 110 (noting that a substantive rule may not be rescinded until the Secretary has “‘published notice of his intention to rescind it, invited comment, put that comment … on the public record, and published a reasoned and reviewable explanation of his decision to rescind [it].'” (quoting Nat’l Wildlife Fed’n v. Watt, 571 F. Supp. 1145, 1156 (D.D.C. 1983))).  This is consistent with procedural regularity and basic fair play required in adjudicating veterans’ claims. See Thurber v. Brown, 5 Vet. App. 119, 123 (1993) (holding that veterans in particular are entitled to “procedural regularity and basic fair play” in the adjudication of their claims); Fugere, 1 Vet. App. at 108 (“‘Where the rights of individuals are affected, it is incumbent upon agencies to follow their own procedures.'” (quoting Morton, 415 U.S. at 235)).

Further, it is clear a properly promulgated regulation trumps an M21–1MR provision or other VA directive that plainly is erroneous or inconsistent with regulation.  Compare Smith v. Shinseki, 647 F.3d 1380, 1385 (Fed. Cir. 2011) (“VA interpretations of its own regulations in its Adjudication Procedures Manual [M21–1MR] are ‘controlling’ as long as they are not ‘plainly erroneous or inconsistent with the regulation.'” (citing Thun v. Shinseki, 572 F.3d 1366, 1369 (Fed.Cir.2009) (quoting Auer v. Robbins, 519 U.S. 452, 461 (1997)))), Haas, 525 F.3d at 1197 (holding that an M21–1MR requirement inconsistent with regulation confers no rights on claimant), and Fournier, 23 Vet. App. at 487–88 (discussing Haas), with Cohen v. Brown, 10 Vet. App. 128, 139 (1997) (“Where the Manual M21–1MR and the regulation overlap, the Manual M21–1MR is irrelevant …. except where the Manual M21–1MR is more favorable to the claimant.”).  See also Castellano v. Shinseki, 25 Vet. App. 146, 150-52 (2011).

The BVA is not free to ignore regulations that the Secretary has promulgated consistent with his statutory authority.  Rather, the “BVA is required to apply all relevant statutes and regulations appropriate to the particular case before it.”  Wilson (Merritte) v. West, 11 Vet. App. 383, 385 (1998) (holding that failure of VA to follow its own regulations in terminating dependency and indemnity compensation benefits, based on severance of service connection, constituted prejudicial error); see also Patton v. West, 12 Vet. App. 272, 283 (1999) (“the Court believes that substantial interests of justice dictate that the Court require the Secretary to adhere to his own regulatory provisions”); Buzinski v. Brown, 6 Vet. App. 360, 367 (1994) (“we agree that … VA is obligated to follow the regulations it promulgates” (citing United States ex rel. Accardi v. Shaughnessy, 347 U.S. 260, 269 (1954); Vitarelli v. Seaton, 359 U.S. 535, 539 (1959))).

OGC Opinions

The Office of General Counsel of the Department of Veterans Affairs (“OGC”) is the Secretary’s law firm.  One role of OGC is to issue written legal opinions on questions of law raised in adjudicating benefits claims.  The General Counsel’s interpretations on legal matters in those opinions are binding on VA officials, the Board, and VA regional offices in adjudications until a change in the law by Congress, a Court decision, or a later written OGC opinion.

The Court, however, is not bound by VA General Counsel precedent opinions.  Hatch v. Principi,18 Vet. App. 527, 531 (2004); see also Theiss v. Principi, 18 Vet. App. 204, 210 (2004); Cottle v. Principi, 14 Vet. App. 329, 335 (2001); Sabonis v. Brown, 6 Vet. App. 426, 429 (1994); see also38 U.S.C. §§ 7104(c), 7261.  The Court reviews the Secretary’s interpretation of law de novo.  See Butts v. Brown, 5 Vet. App. 532, 539 (1993) (en banc).  Hatch v. Principi, 18 Vet. App. 527, 531 (2004).

M21-1MR Manual

It is very difficult to run an organization as large as the VA with only the formal rules in the Code of Federal Regulations.  So, as with many other federal agencies, VA has developed all sorts of “informal” guidance for its employees to use in performing day-to-day work.  This guidance can be in the form of manuals, “letters,” “memos,” or policies.  Although no one challenges the usefulness of such “guidance,” whether or not these types of documents are the “law” can be an important issue in litigation where a claimant challenges the way VA handles his or her claim.

VA has developed a detailed procedures manual, the Compensation and Pension Manual Rewrite (designated by VA as the “M21-1 MR” manual), to guide its raters and reviewing officials who adjudicate benefits claims.  The M21-1 MR is primarily “an internal manual used to convey guidance to VA adjudicators [and] not intended to establish substantive rules beyond those contained in statutes and regulations.”  See Guerra v. Shinseki, 642 F.3d 1046, 1050-51 (Fed. Cir. 2011) (quoting 72 Fed. Reg. 66,218 (Nov. 27, 2007)).  In other words, the M21-1MR is only guidance for VA personnel and the guidance in the M21-1MR does not replace or overrule Congress’s statutes or VA’s regulations.

Because it can take a long time and significant effort to complete a rulemaking and because many VA rules were created before Court review was available, VA sometimes tries to enforce M21-1MR guidance as if it were a regulation.  The Court, however, has determined that the placement of a rule “in a procedural manual cannot disguise its true nature as a substantive rule,” Fugere v. Derwinski, 1 Vet. App. 103, 107 (1990), aff’d, 972 F.2d 331 (Fed. Cir. 1992), because substantive rules are deemed “the equivalent of VA regulations.”  Cohen v. Brown, 10 Vet. App. 128, 139 (1997).  This means that if there is a conflict between the M21-1MR manual and a substantive rule (a statute in the U.S.C. or a C.F.R. rule), the statute or rule prevails.  In other words, just because the VA says that the M21-1MR requires something does not mean that the law necessarily requires the same thing.  If the issue is important to an award, a claimant should do further research to see if the relevant regulation and statute require a different action or result.

Other VA Policies, Procedures, and Guidance

In certain circumstances, M21-1MR provisions may be construed as “the equivalent of Department regulations.”  See Hamilton v. Derwinski, 2 Vet. App. 671, 675 (1992) (holding that substantive rules in the M21-1MR Manual are binding on VA).  As such, the Board errs when it fails to consider a M21-1MR provision’s possible relevance with respect to VA’s compliance with the duty to assist.  See 38 U.S.C. § 7104(a).  Likewise, the Board should consider the applicability of Fast Letters or predecessors.  Id.see also United States v. Picciotto, 875 F.2d 345 (D.C. Cir. 1989).  Such a policy does not create “new substantive law” it merely clarifies the applicable regulation by “provid[ing] concrete guidance as how” the regulation should “be applied in practice.”  Stinson v. United States, 508 U.S. 36, 44 (1993) (holding that the sentencing commission’s commentary to the sentencing guidelines is treated as an agency’s interpretation of its own legislative rule).

Moreover, a handbook “reflect[s] the agency’s fair and considered judgment on the matter in question.”  Auer v. Robbins, 519 U.S. 452, 462 (1997).  When a handbook was created prior to pending litigation and the policy prescribed therein is consistent with the information provided in other guidance documents issued by the Secretary, the handbook is “in no sense a ‘post hocrationalizatio[n]’ advanced by an agency seeking to defend past agency action against attack.”  Auer, 519 U.S. at 462 (quoting Bowen v. Georgetown Univ., 488 U.S. 204, 212 (1988)).  In order for VA handbooks, circulars, and manuals to have the “force and effect of law” they must “prescribe substantive rules—not interpretive rules.”  Rank v. Nimmo, 677 F.2d 692, 698 (9th Cir. 1982).  The Rank court found that the VA Lender’s Handbook and VA Circular 26–75–8 did not prescribe substantive rules but were “general statements of agency policy and procedure” intended as a “general guide to VA employees,” and thus there was no enforceable duty on the part of the VA to “take all reasonable measures to avoid foreclosure.”  Rank II, 677 F.2d at 698.

The distinction set out in Rank II between “substantive” and “interpretive” rules is similar to this Court’s analysis.  Fugere v. Derwinski, 1 Vet. App. 103, 107–08 (1990) (noting the distinction between “substantive” and “interpretive” rules for enforceability purposes, and holding that a VA manual provision regulating the award of benefits for defective hearing “affected a substantive right and [that] its placement in a procedural manual [could not] disguise its true nature as a substantive rule.”); see also Hayes v. Brown, 4 Vet. App. 353, 360 (1993); Suttmann v. Brown, 5 Vet. App. 127, 138 (1993).  The VA issuances discussed in Rank II, 677 F.2d at 694–95, imposed no specific mandatory duties on VA employees as distinguished from providing general guidance.  Buzinski v. Brown, 6 Vet. App. 360, 369 (1994).

However, “not all agency policy pronouncements which find their way to the public can be considered regulations enforceable in federal court.”  Chasse v. Chasen, 595 F.2d 59, 62 (1st Cir. 1979).  “[I]n order for VA handbooks, circulars, and manuals to have the ‘force and effect of law’ they must ‘prescribe substantive rules—not interpretive rules.'” Buzinski v. Brown, 6 Vet. App. 360, 369 (1994) (quoting Rank v. Nimmo, 677 F.2d 692, 698 (9th Cir.1982)).  Such a result is also possible as to VA issuances that predate the VCAA, should a VA adjudication under the implementing regulations provide a result less favorable than would have been provided under those pre-VCAA issuances.  See, e.g., McCormick v. Gober, 14 Vet. App. 39 (2000) (holding that VBA Letter 20-99-60 was binding VA issuance although not adopted after notice and opportunity for public comment); Morton, supra (as to withdrawal of opinion); Patton v. West, 12 Vet. App. 272, 277-84 (1999) (holding certain parts of VA Adjudication Procedure Manual, M21-1MR, were binding on VA); Cohen (Douglas) v. Brown, 10 Vet. App. 128, 139 (1997) (same).  Holliday v. Principi, 14 Vet. App. 280, 292 (2001) overruled by Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003).

The VA “Clinician’s Guide” is an instructive, but not a binding, document and allows each VA examiner discretion as to how to conduct an examination in an individual case.  See Allin v. Brown, 6 Vet. App. 207, 214 (1994).  The first chapter of the Guide states, “[t]he Clinicians Guide and any of its parts (worksheets) are intended solely as a guide for clinicians, and it is not legally binding on a clinician to perform all portions of the examination protocol.”  VA Clinician’s Guide, § 1.1 (2002).  Moreover, to the extent that an appellant disagrees with the qualifications or conclusions of the medical examiner, the competency of VA examiners is to be presumed, based on the presumption of regularity, in the absence of evidence to the contrary.  Rizzo v. Shinseki, 580 F.3d 1288 (Fed. Cir. 2009); Cox v. Nicholson, 20 Vet. App. 563, 569 (2007) (citing Hilkert v. West, 12 Vet. App. 145, 151 (1999), aff’d per curiam, 232 F.3d 908 (Fed. Cir. 2000) (table)). Because the examiner is presumed competent, the examiner’s medical judgments, such as what tests to perform and what details of an examination are salient, are also presumed to be sound in the absence of sufficient contrary evidence.  See, e.g., Sickles v. Shinseki, 643 F.3d 1362, 1366 (Fed. Cir. 2011) (due to presumed competency of medical examiner, Board was entitled to presume that a VA medical examination was sufficiently informed by a physical examination or other diagnostic procedures selected by the examiner); see also Rizzo, 580 F.3d at 1292 (the presumption of regularity may be rebutted by the submission of clear evidence to the contrary).

You may also see references to “38 U.S.C.S.” (United States Code Service”) or “38 U.S.C.A.”  (United States Code Annotated).  These are versions of the United States Code published by non-governmental organizations and which provide additional comments or references in addition to the statute itself.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision!

Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims!

Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

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